DumpingSyndrom

Dumping syndrome, known in German as DumpingSyndrom, is a collection of symptoms that can occur after gastric surgery when food moves too rapidly from the stomach into the small intestine. It is most commonly seen after procedures that alter gastric emptying, such as gastrectomy, Roux-en-Y gastric bypass, pyloroplasty, or vagotomy. The condition results from rapid delivery of undigested, osmotically active contents into the small intestine, triggering fluid shifts into the bowel, intestinal distension, and an exaggerated hormonal response.

There are two main forms: early dumping and late dumping. Early dumping occurs roughly 15 to 30 minutes after a meal and features gastrointestinal symptoms (nausea, bloating, abdominal cramps, diarrhea) with vasomotor signs (flushing, rapid heartbeat, dizziness). Late dumping occurs about 1 to 3 hours after eating and is primarily due to hypoglycemia from excessive insulin release, causing sweating, tremor, confusion, and weakness.

Diagnosis is largely clinical and based on history after gastric surgery; tests such as gastric emptying scintigraphy or specialized glucose tolerance testing can support the diagnosis. Management focuses on dietary and lifestyle changes and, when needed, medications. Dietary measures include smaller, more frequent meals; higher protein and fiber intake; reduction of simple sugars; limiting liquids with meals; and separating fluids and solids. Medications such as acarbose or somatostatin analogs (octreotide) may help in persistent or severe cases. Most patients improve with treatment, though some experience ongoing symptoms or nutritional concerns.